MEDICARE: LENAIR MARIE SPARKS LPC/MHSP (T)

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YM0800X	Mental Health Counselor

General Provider Information

NPI Number	:	1174348726
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LENAIR MARIE SPARKS LPC/MHSP (T)

Provider Business Mailing Address
First Line	:	105 ROSE HILL CT
Second Line	:
City	:	FRANKLIN
State	:	TN
Zip	:	37069-1855
Country	:	US
Telephone Number	:	615-495-2698
Fax Number	:

Provider Business Practice Location Address
First Line	:	4317 LONG LN
Second Line	:
City	:	FRANKLIN
State	:	TN
Zip	:	37064-7206
Country	:	US
Telephone Number	:	615-591-5262
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/19/2024
Last Update Date	:	11/19/2024

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Directions to “ LENAIR MARIE SPARKS LPC/MHSP (T)” Practice Location

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